Eye Floaters and Flashes
Viewing an image or a burst of light occasionally can be a pleasant surprise. When they become regular features, this could signal eye floaters and flashes. A floater is a continually changing, moving object, while flashes are bright spots in your field of vision. While generally harmless and not requiring treatment, they could indicate more serious conditions, such as a retinal tear or detachment, requiring immediate medical attention. Your ophthalmologist must regularly monitor you for floaters and flashes. At Retina Consultants of Charleston, we diagnose and treat these conditions. If identified early, you can expect improved vision, with few subsequent issues.
What To Know About Eye Floaters
You may have noticed a “blob” or any other object taking on different appearances, like spots, squiggly lines, or shadowy shapes. If so, you’re probably dealing with a floater, which moves in the direction you look. No matter how often you blink, they’re permanent, but over time, you’ll probably stop noticing them. Very common, floaters usually occur in one eye at a time. They usually develop between the years of 50 and 70. Among people over the age of 50, 75% experience them, increasing to 87% among people 80-89 years old.
Although a floater now and then is usually nothing to worry about, you need to tell your ophthalmologist about them during your comprehensive, dilated eye exam. Floaters may be mistaken for other conditions, particularly if you suddenly see a burst of them, or you see many. These incidents may be a sign that you have a torn retina or one that will soon detach, which is considered a severe vision emergency. You must quickly alert your ophthalmologist if you observe any of the following:
- Flashes or floaters suddenly multiply
- Suddenly seeing gray or dark floaters or repeated flashes of light
- Experiencing visual distortions
- Having a dark area or “curtain” in your field of vision
- Seeing flashes after being hit in the eye or face
If you are experiencing a sudden increase in floaters and flashes, shadows or blurriness in your peripheral vision, or a curtain appearing over part of your vision, seek medical care right away. Retinal tears and detachments are medical emergencies that need to be addressed as quickly as possible. Our office provides on-call service for emergencies, 24 hours a day, 7 days a week. Call (843) 763-4466 and Dr. Alfaro will be contacted immediately.
Posterior Vitreous Detachment
While there may be several causes for floaters, typically, they form due to posterior vitreous detachment (PVD). A normal feature of aging, PVD involves the slow, gradual shrinking of the vitreous. Also called the vitreous gel or humor, this clear gel, filling up to 80% of your eye’s total volume, supports its structure and provides a clear passageway for light to reach the retina, in the back of the eye. As the vitreous becomes smaller, it pulls on the retina, and in the process, tiny particles form and slowly drift in front of the retina’s center part, the macula.
Other Causes of Floaters
Should a floater not form due to PVD or as a symptom of a more serious retinal tear or detachment, there are other potential causes. If you are myopic (nearsighted), this boosts the likelihood of their development, especially for younger people. Research shows that the vitreous ages faster the more myopic your eyes. Myopia also increases retinal tear and detachment risks, which are closely associated with floater development. However, children under 16 years of age are unlikely to have floaters, unless related to eye disease.
Floaters may appear if you have blood in your eye, which is often associated with diabetic retinopathy. With this incurable condition, high blood sugar levels, due to diabetes, damage the retina’s tiny blood vessels. They may also develop if:
- You’ve had cataract surgery.
- You had previous eye issues, like swelling within your eye.
- You have uveitis, a condition involving inflammation within your eye.
- You had an eye injury.
What To Know About Flashes
Flashes, or photopsias, are generally described as streaks of light, bursts, or jagged light similar to lightning bolts. They typically occur in one eye at a time, appearing early in the morning and fading throughout the day, or when you’re in a dark room.
Typical Causes of Flashes
Like floaters, flashes may indicate a retinal tear or detachment. Rarely, they may be a sign of another underlying condition, retinitis pigmentosa, involving the deterioration of retinal cells. Flashes may also be due to ocular migraine, a condition usually affecting younger people characterized by flashes that may look like zig-zag shapes, orbs of light, or blind spots. These migraines may not always be accompanied by headaches.
Flashes can develop if you have family members who have had retinal detachments. Your risks for floaters may increase if you had eye surgery, such as for cataracts or glaucoma, or if you take glaucoma medication. Additionally, following an injury, you may notice flashes.
Diagnostic Methods of Floaters and Flashes
It’s crucial to regularly monitor floaters and flashes, with a comprehensive, dilated eye exam. This enables your ophthalmologist to quickly detect and diagnose them, so they can initiate treatment as early as possible. They may also press on your eyelids to check for retinal tears. In the event the exam is unsuccessful at finding the cause, additional testing, such as an ultrasound of the eye, may be ordered.
Treating Floaters and Flashes
As the cause of the majority of floaters and flashes is normal aging, typically, these conditions will not require any treatment, other than regular monitoring. However, if they may have developed due to another cause, it may then be necessary to treat the underlying issue(s), particularly if a retinal detachment is involved.
Should treatment be needed, you may require a vitrectomy, a minimally invasive surgery that takes about 45 minutes to 2 hours to complete, in an operating room setting. It involves a surgeon making very tiny incisions through the sclera (the eye’s white part), to remove part or all of the vitreous being from the back of the eye. This affords surgeons unobstructed access to the retina and nearby parts. You may have additional procedures, such as fixing a retinal detachment, performed afterward.
Your vitreous may be replaced with another substance, like gas or a balanced saline solution. A few days later, this will be replaced with aqueous humor, naturally produced by your eye. Vitrectomy is highly successful, with single-surgery success rates approaching 95%, and there should be little effect on your eye health. The healthier your eye before surgery, the likelier it will heal quickly and vision will improve. You may also undergo a different procedure, vitreolysis, which involves a special laser that breaks up the floaters, to make them less noticeable.
Treatment for Flashes
If you experience flashes occasionally, treatment is not recommended. However, if they’re appearing frequently, your ophthalmologist may opt to treat the underlying cause, generally with a procedure like laser repair or cryotherapy (freezing). If diabetic retinopathy is at fault, resulting in retinal scarring, one of the following may be needed: laser treatment to remove new blood vessels, eye injections to prevent new blood vessel development, or eye surgery to remove scarring. Should retinal detachment be the cause, surgery is often necessary, such as a vitrectomy.
You may also undergo a simple technique known as pneumatic retinopexy. Performed in the doctor’s office, it usually takes about 30 minutes to complete, and has a high success rate, with quick healing. It’s often most successful in patients with one tear located in the top half of the retina. Pneumatic retinopexy is also a good option for patients with natural lenses, rather than those who have had cataract surgery.
With this procedure, a gas bubble is injected with a small needle into the vitreous cavity, through the sclera. Using a device called an ophthalmoscope to ensure the bubble is in the proper location, the torn retina is pushed to close. A freezing instrument helps seal the retina against the eye wall. As you heal, new fluid fills the eye. You may have additional treatments performed with this procedure. You may have laser treatment, rather than freezing, to seal the tear(s) after the fluid has dissipated.
Your retinal specialist may perform a scleral buckle procedure, involving a small piece of silicone sponge or semi-hard plastic being placed on the sclera. This secures the detached retina in place until a seal forms. The surgeon may use a device, typically, a freezing device, to seal your retina back to the eye’s inner wall. They’ll also remove any vitreal liquid that has seeped under the retina. Additional procedures may be performed to treat retinal breaks or weakened areas. Generally, you can go home the same day, although someone will need to drive you. If the procedure does not work, you may require additional surgery.
Learn How Floaters and Flashes Can Be Managed and Treated
Eye floaters and flashes are generally harmless, but as they may indicate more serious conditions, regular monitoring is vital. Should they disrupt your quality of life, or you require treatment for an underlying cause, we invite you to contact Retina Consultants of Charleston for an appointment with our retina specialists.